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NPI Code Detail

MEDICARE: MS. DEBORAH CAROL DICKENS

MEDICARE: MS. DEBORAH CAROL DICKENS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) CounselorA019690715CA

General Provider Information

NPI Number : 1194820787
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. DEBORAH CAROL DICKENS
Provider Business Mailing Address
First Line : 2060 CAMPUS DR
Second Line :
City : YREKA
State : CA
Zip : 96097-9538
Country : US
Telephone Number : 530-841-4803
Fax Number :
Provider Business Practice Location Address
First Line : 2060 CAMPUS DR
Second Line :
City : YREKA
State : CA
Zip : 96097-9538
Country : US
Telephone Number : 530-841-4803
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/14/2006
Last Update Date : 10/15/2015

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Directions to “ MS. DEBORAH CAROL DICKENS ” Practice Location

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